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Do bites of kissing bugs cause unexplained allergies? Results from a survey in triatomine-exposed and unexposed areas in southern california.

ABSTRACT: BACKGROUND: The bite of Triatominae can cause cutaneous allergic reactions and even anaphylaxis. Since the early 1980s, no population-based surveys have been done in Southern California, and none was ever carried out in inland Los Angeles or Riverside Counties. OBJECTIVES: To measure the frequency of insect sightings, bites and allergic reactions in a suburban area of eastern Los Angeles County and along with rural and urban sites in Riverside County. METHODS: A door-to-door survey was done in triatomine exposed and unexposed areas. Logistic regression modeling was used for the analysis, and study participants were asked to collect insects. RESULTS: Out of the 221 study participants in the exposed areas, 46 (20%) knew about the presence of Triatominae in their neighborhood. Fifteen (7%) persons reported triatomine sightings in their house during the month preceding the interview. Also, 15 (7%) participants reported ever being bitten by a triatomine. Ten (5%) participants collected either a Triatoma protracta Uhler and/or Paratriatoma hirsuta Barber in and around their house. Twenty-nine (13%) persons in the rural Riverside County reported symptoms compatible with allergy to triatomine bites. This was 4 times higher than in the urban control area where only 4 (3%) of 115 persons reported these symptoms. The association between living in a triatomine-exposed area and self-reported symptoms suggestive of allergies increased slightly when adjusted for the participant's sex and the age of their house (adjusted odds ratio: 5.1, 95% confidence interval: 1.2 to 22.0). Reporting these symptoms was associated with seeing Triatominae in the neighborhood and having been bitten. CONCLUSION: Allergies to triatomine bites could be a significant problem in inland Southern California. Further investigations, a diagnostic test and better information of persons living in triatomine-exposed areas are needed.

SUBMITTER: Walter J

PROVIDER: S-EPMC3429444 | biostudies-other | 2012

REPOSITORIES: biostudies-other

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Project description:BACKGROUND:Two health concerns primarily related to triatomine bugs are transmission of Trypanosoma cruzi through infective feces, and allergic reactions induced by triatomine bites. In the Southwestern United States, reduviid bugs bites commonly cause insect allergy. In South China, four cases of anaphylactic shock have been reported after this bite exposure. To further classify the species of these bugs and confirm the sensitization of the triatomine saliva, we caught triatomine bugs from the region where the bites occurred and performed phylogenetic and immunohistochemical (IHC) analysis. METHODS:Triatomine bugs were collected in Donghai Island of Zhanjiang City in South China. The genomic DNA was extracted from three legs of the bugs. The fragments of mitochondrial 16S rRNA, cytochrome c oxidase subunit I (COI) gene and nuclear ribosomal 18S and 28S rRNA genes were obtained by PCR and sequenced. A phylogenetic tree was constructed based on the sequence of 16S rRNA gene using a maximum likelihood method with MEGA 7.0 software. Trypanosomal specific fragments and vertebrate COI genes were amplified from the fecal DNA to detect the infection of trypanosomes and analyze the blood feeding patterns, respectively. Paraffin-embedded sections were then prepared from adult triatomines and sent for IHC staining. RESULTS:We collected two adult triatomine bugs in Donghai Island. Morphological and molecular analyses indicated that the triatomines were Triatoma rubrofasciata. No fragments of T. cruzi or other trypanosomes were detected from the fecal DNA. Mitochondrial gene segments of Homo sapiens and Mus musculus were successfully amplified. The allergens which induced specific IgE antibodies in human serum were localized in the triatomine saliva by IHC assay. CONCLUSIONS:The two triatomine bugs from Donghai Island were T. rubrofasciata. They had bitten humans and mice. Their saliva should contain the allergens related to the allergic symptoms and even anaphylactic shock of exposed residents. Great consideration should be given to this triatomine bugs due to their considerable distribution and potential threat to public health in South China.

Project description:Colorectal cancer (CRC) screening can reduce cancer deaths. However, screening and abnormal test follow-up rates are low among underserved populations. The screening rates of 19-58%, and rates of colonoscopy completion after abnormal stool tests of 18-57% in community health centers (CHC) systems are low. This highlights an opportunity to improve early detection and decrease burden of CRC in our region. Mailed outreach and navigation programs have been shown to increase colonoscopy completion rate. The next step is to understand how to best implement these programs in the community on a larger scale. To achieve this goal, the investigators propose a Hub-and-Spoke intervention combining centralized strategies to maximize CRC screening, follow-up, and referral-to-care. The investigators hypothesize that this intervention will be superior to usual care for increasing CRC screening, abnormal test follow-up, and referral-to-care. The investigators will conduct a randomized trial to determine effectiveness in: 1) improvement in proportion of individuals up-to-date with screening 3 years post implementation; 2) proportion with abnormal FIT who complete diagnostic colonoscopy within 6 months; and 3) proportion with CRC completing first treatment evaluation. The investigators will also evaluate the implementation, scalability, and sustainability of the multi-level implementation strategy. The intervention consists of: Mailed FIT and Reminders. Eligible individuals will receive an introductory letter describing the importance of CRC screening and noting that follow-up mail will include a FIT Kit. It will also be offered to patients who completed prior mailed FIT with normal test results. All materials will be in English and Spanish. Two weeks later, participants will receive a packet via mail containing the FIT kit, a one-page invitation inviting FIT completion and FIT instructions, a postage-paid envelope for return to the patient’s CHC, and COVID-19 message. For non-compliant individuals not returning the kit, a reminder phone call and text message will be delivered 2 weeks later. The investigators will track returned letters, individuals who are later found to be up-to date with screening, and those who decline screening. The CHC will provide care coordination for patients with an abnormal FIT result.

Project description:BackgroundFailure to detect a disease agent or vector where it actually occurs constitutes a serious drawback in epidemiology. In the pervasive situation where no sampling technique is perfect, the explicit analytical treatment of detection failure becomes a key step in the estimation of epidemiological parameters. We illustrate this approach with a study of Attalea palm tree infestation by Rhodnius spp. (Triatominae), the most important vectors of Chagas disease (CD) in northern South America.Methodology/principal findingsThe probability of detecting triatomines in infested palms is estimated by repeatedly sampling each palm. This knowledge is used to derive an unbiased estimate of the biologically relevant probability of palm infestation. We combine maximum-likelihood analysis and information-theoretic model selection to test the relationships between environmental covariates and infestation of 298 Amazonian palm trees over three spatial scales: region within Amazonia, landscape, and individual palm. Palm infestation estimates are high (40-60%) across regions, and well above the observed infestation rate (24%). Detection probability is higher ( approximately 0.55 on average) in the richest-soil region than elsewhere ( approximately 0.08). Infestation estimates are similar in forest and rural areas, but lower in urban landscapes. Finally, individual palm covariates (accumulated organic matter and stem height) explain most of infestation rate variation.Conclusions/significanceIndividual palm attributes appear as key drivers of infestation, suggesting that CD surveillance must incorporate local-scale knowledge and that peridomestic palm tree management might help lower transmission risk. Vector populations are probably denser in rich-soil sub-regions, where CD prevalence tends to be higher; this suggests a target for research on broad-scale risk mapping. Landscape-scale effects indicate that palm triatomine populations can endure deforestation in rural areas, but become rarer in heavily disturbed urban settings. Our methodological approach has wide application in infectious disease research; by improving eco-epidemiological parameter estimation, it can also significantly strengthen vector surveillance-control strategies.

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Do bites of kissing bugs cause unexplained allergies? Results from a survey in triatomine-exposed and unexposed areas in southern california.

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